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Vision Therapy for Children with Special Needs

Vision Problems and Special Needs Children

When a child or adult has 20/20 vision but is unable to differentiate between a triangle and a square, the eyes are not a problem, the issue is with visual processing skills. It is the brain and not the eyes that processes the visual world including things like symbols, pictures, and distances.

There are eight types of visual processing issues

  • Visual discrimination issue wherein there is a difficulty in seeing the difference between two similar letters or objects. e.g. confusing d and b, p and q.
  • Visual figure ground discrimination issues wherein kids find it difficult to find a specific piece of information on a page.
  • Visual sequencing issues wherein there is a difficulty in telling the order of symbols, words or images. They skip lines when reading and misread letters numbers and words.
  • Visual motor processing- The kids find it difficult to use information taken from the eyes to coordinate movement of other parts of their body so they bump into things or may have trouble copying from a book.
  • Long or short term visual memory issues- They have trouble remember what they have read and using calculators and key boards.
  • Visual spatial issues- The kids are unable to make out how far the things are from them and from each other. They find it difficult to read maps and judging time.
  • Visual closure issues- Kids find it difficult to identify an object if parts of it is missing e.g. if a letter is missing, they may not recognize the word.
  • Letter and symbol reversal issues- They switch letters or umbers while writing and this may affect their math skills.

Common symptoms of visual processing issues are

  • The child does not pay attention to visual tasks
  • Is easily distracted by too much visual information
  • Is restless or inattentive during video or visual presentations
  • Lacks interest in movies or television
  • Has difficulty with tasks that require copying e.g. taking notes from a board
  • reverses or misreads letter, numbers and words
  • bumps into things
  • Has difficulty writing within lines or margins
  • Has trouble spelling familiar words with irregular words or patterns
  • Can’t remember phone numbers
  • Has poor comprehension when reading silently
  • Can’t remember basic facts that were read silently
  • Skips words or entire lines when reading or reads the same line over and over again
  • Complains of eye strain and rubs eyes frequently
  • Has below average reading comprehension and writing skills despite having oral comprehension and verbal skills
  • Has weak math skills
  • Fails to observe or recognize changes on bulletin boards, road signs etc.

How Vision Therapy Helps?

Visual therapy is a form of neurological training or rehabilitation that involves specifically prescribed procedures addressing the diagnosed vision condition. In some cases, visual training is the only available and effective treatment option for these conditions. These procedures are to improve visual skills such as eye teaming, depth perception, focusing, eye movements and eye-hand coordination.

  • Eye tracking: the ability of the eyes to follow a moving target such as in sports or to reposition the eyes as in reading.
  • Eye Teaming : the ability to control the two eyes together so you don’t see double.
  • Depth Perception : the ability to judge distances correctly and see in 3 dimensions.
  • Fixation : the ability to keep the eyes pointed at a particular target.
  • Visual Attention : the ability to maintain attention during periods of intense nearwork.
  • Eye Focusing : the ability to change and maintain clarity.
  • Visual Thinking : the ability to form concepts in your mind and see visual imagery.
  • Visual Memory : the ability to retain visual information over time.
  • Visual & motor planning: the ability to think ahead visually before performing tasks.

Visual processing issues affects the academic performance of the kids which leads to emotional disturbance and low self-esteem. It makes life skills and simple tasks difficult for them.

How can visual processing issues be diagnosed & managed?

A visit to the developmental pediatricians, pediatric ophthalmologists, pediatric optometrists, behavioral optometrists can help detect this problem in children & adults. Vision therapy, which involves a variety of exercises using devices like prisms lenses and computerized programs can help resolve issues with visual processing.

Conditions

  • ADD/ADHD & Vision
  • Autism & Vision
  • Dyslexia
  • Dyscalculia
  • Dysgraphia

ADD ADHD AND VISION

Some children with learning difficulties exhibit specific behaviors of impulsivity, hyperactivity, and distractibility. A common term used to describe children who exhibit such behaviors is Attention Deficit Hyperactivity Disorder (ADHD). Undetected and untreated vision problems can elicit some of the very same signs and symptoms that are commonly attributed to ADHD. Due to these similarities, some children with vision problems are mislabeled as having ADHD.

AUTISM AND VISION

What is Autism?

Autism is a neurobiological disorder. People with autism have difficulty processing and responding to information from their senses. They also have difficulties with communication and social interaction.

Symptoms of autism can include lack of reciprocal social interaction, delays in development, and inappropriate response to sensory information.

Visual Problems and Autism

Symptoms of autism can include lack of eye contact, staring at spinning objects or light, fleeting peripheral glances, and side viewing. Autistic people usually use visual information inefficiently. They suffer from issues with coordinating their central and visual modality. For instance, when asked to follow an object with their eyes, they usually do not look directly at the object. Instead, they will scan or look off to the side of the object.

Poor Integration of Central and Peripheral Vision

Autistic individuals can also ignore peripheral vision and remain fixated on a central point of focus for excessive periods of time. Poor integration of central and peripheral vision can lead to difficulties in processing and integrating visual information in autistic individuals. Motor, cognitive, speech, and sensory activity can be affected once a visual process is interrupted.

Hypersensitive Touch and Vision

People suffering from autism are tactually or visually defensive. The former are easily over-stimulated by input through touch and avoid contact with specific textures while the later avoid contact with specific visual input and might have hypersensitive vision.

Vision Exams for Autistic Patients

Evaluating the vision of people with autism varies depending on the individual’s levels of emotional and physical development. Testing is often done while the patient is asked to perform specific activities while wearing special lenses. For example, observations of the patient’s postural adaptations and compensations will be made as he or she catches and throws a ball, walks, sits, stands, etc. Such tests help to determine how the autistic person is seeing and how he or she can be helped.

Treatment of Visual Problems Associated with Autism

Depending on the results of testing, lenses are prescribed to compensate for near-sightedness, farsightedness, and astigmatism. Vision Therapy activities can be used to stimulate general visual arousal, eye movements, and the central visual system. The treatment helps autistic patients organize visual space and gain peripheral stability so that they can better attend to and appreciate the central vision and gain more efficient eye coordination and visual information processing.

DYSLEXIA

Children and Adults with this condition usually have sharp eyesight. However, they have symptoms related to problems with eye-teaming, eye-tracking, and perceptual issues that cause words letters and numbers to appear to move or jump on a page. Depending upon the severity, learning disability related vision problems disappear once eye-teaming/tracking and perceptual vision skills are strengthened.

DYSCALCULIA

Those affected by dyscalculia have difficulty in making arithmetical calculations. It is a specific developmental disorder which may occur due to brain trauma and is also associated with Turner’s syndrome. 3%-8% of school-aged students have math-related learning disabilities. Such children have difficulties reading analog clocks and have difficulty in determining the relative size of objects. They may find it difficult to estimate the cost of items in a shopping basket, for example. Other difficulties may be in managing time, mental visualization, following choreographed dance steps, mental mathematics, reading maps, recollecting names for faces (poor name face retrieval) or in the perception of depth and distance.

Role of Eyes

A large amount of clinical evidence shows that children with this condition have an eye-tracking problem with unidentifiable fixation patterns coupled with difficulty with especially representing and manipulating numerosities on a number line. Hence, tasks that improve eye-tracking in combination with number line estimations are valuable in the current management strategies. The problem lies in cognitive processing in the brain.

Hence, management involves specific computerized vision therapy programs that enhance eye fixation visual attention and visual recall. Eye tracking exercises have shown great efficacy in management of this condition{Author K. MOLLER; cognitive development 24 (2009) pp 371-386}

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